A case of reversible cardiomyopathy associated with acute toluene exposure

Yaşar, Salim; Yıldırım, Erkan; Köklü, Mustafa; Gürsoy, Erol; Çelik, Murat; Yuksel, Uygar Cagdas

doi:10.1016/j.tjem.2016.09.002

Cited by 8 publications

(6 citation statements)

References 10 publications

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“… 12 However, hypokalaemia and sodium channel blockage and vasospasm associated with endogenous catecholamines or ischaemia may underlie cardiotoxic effects caused by toluene, such as cardiomyopathy, recurrent VF and death. 2 Increased lactic acidosis as a result of cardiogenic shock is the key factor underlying the cause of severe metabolic acidosis in our patient. There is no specific treatment for cardiotoxicity developing following hydrocarbon exposure.…”

Section: Discussionmentioning

confidence: 63%

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Successful resuscitation of prolonged cardiac arrest occurring in association with ‘skunk’ and toluene toxicity

Şahin

Özer

Akkaya

et al. 2018

Turkish Journal of Emergency Medicine

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We report a case of prolonged and successful resuscitation following cardiotoxicity-related arrest occurring after inhaling toluene and Skunk, which is an increasingly popular synthetic cannabinoid (SC). Following presentation to the emergency department because of lethargy, nausea and chest pain, a 28-year-old male user of Skunk and toluene suffered from cardiac arrest due to ventricular fibrillation (VF). Cardiogenic shock, severe metabolic acidosis and regular wide QRS tachycardia were observed in the patient, and he developed VF every 5–10 minutes over the course of 10 hours. The patient responded to prolonged resuscitation and was discharged on 8th day of his admission in a healthy condition. This case report is the first report that cardiac arrest occurring as a result of Skunk and toluene inhalation, which was resolved without sequelae after prolonged resuscitation.

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Section: Discussionmentioning

confidence: 63%

“…Toluene is an organic solvent and aromatic hydrocarbon that causes central nervous system depression, fatal cardiac dysrhythmia and renal and hepatic toxicity following inhalation or ingestion. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Successful resuscitation of prolonged cardiac arrest occurring in association with ‘skunk’ and toluene toxicity

Şahin

Özer

Akkaya

et al. 2018

Turkish Journal of Emergency Medicine

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“…In addition, many studies had already investigated that the changes in heart rates and ECG were the most reported cases of the toluene effect on cardiac function [ 88 , 89 , 90 ]. Moreover, cardiac toxicity occurs in some cases throughout its direct or indirect cardiotoxic effects, even in acute exposure with relatively low concentrations [ 91 ]. The current results also contradicted another finding from another study in sulfonamide.…”

Section: Discussionmentioning

confidence: 99%

Toxicity Assessment of an Anti-Cancer Drug of p-Toluene Sulfonamide in Zebrafish Larvae Based on Cardiovascular and Locomotion Activities

et al. 2022

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p-toluene sulfonamide (p-TSA), a small molecular drug with antineoplastic activity is widely gaining interest from researchers because of its pharmacological activities. In this study, we explored the potential cardio and neural toxicity of p-TSA in sublethal concentrations by using zebrafish as an in vivo animal model. Based on the acute toxicity assay, the 96hr LC50 was estimated as 204.3 ppm, suggesting the overall toxicity of p-TSA is relatively low in zebrafish larvae. For the cardiotoxicity test, we found that p-TSA caused only a minor alteration in treated larvae after no overall significant alterations were observed in cardiac rhythm and cardiac physiology parameters, as supported by the results from expression level measurements of several cardiac development marker genes. On the other hand, we found that acute p-TSA exposure significantly increased the larval locomotion activity during the photomotor test while prolonged exposure (4 days) reduced the locomotor startle reflex activities in zebrafish. In addition, a higher respiratory rate and blood flow velocity was also observed in the acutely treated fish groups compared to the untreated group. Finally, by molecular docking, we found that p-TSA has a moderate binding affinity to skeletal muscle myosin II subfragment 1 (S1), ATPase activity, actin- and Ca2+-stimulated myosin S1 ATPase, and v-type proton ATPase. These binding interactions between p-TSA and proteins offer insights into the potential molecular mechanism of action of p-TSA on observed altered responses toward photo and vibration stimuli and minor altered vascular performance in the zebrafish larvae.

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“…Experimental studies have shown that toluene could have a direct cardiotoxic effect on the myocardium and induce vasospasms and cardiac conduction system abnormalities [3].Case reports and series have also reported cases of acute heart failure, arrhythmias, coronary vasospasm and cardiomyopathy [4] [5]. In most cases, the effect of toluene was described as short-timed and reversible, but case reports have also reported cases of chronic heart failure [6].…”

Section: Discussionmentioning

confidence: 99%

“…3 Case reports and series have also reported cases of acute heart failure, arrhythmias, coronary vasospasm, and cardiomyopathy. 4 , 5 In most cases, the effect of toluene is described as being short-term and reversible, but case reports have also reported cases of chronic heart failure. 6 …”

Section: Discussionmentioning

confidence: 99%